Articaine, 40 ml/ml 1.7 ml cartridge 50 pcs.

Articaine is a local anesthetic (thiophene derivative) for infiltration and conduction anesthesia in dental practice, has a pronounced local anesthetic effect. In tissues (in low-alkaline environment) it undergoes hydrolysis and releases base, which has lipophilic properties and easily penetrates through the membrane into the nerve fiber.

Articaine interacts with the receptors and blocks the sodium channels in the nerve fiber membrane, thus providing a local anesthetic effect.

The action of the drug starts quickly (latency period is 1-3 minutes). The duration of action is 20 minutes. Rapid destruction of articaine to inactive metabolite – articic acid – is the reason of its very low toxicity, which allows repeated administration of the drug. In an acidic environment the effect is reduced.

Indications

— infiltration and conduction anesthesia in dentistry.

Pharmacological effect

Articaine is a local anesthetic (thiophene derivative) for infiltration and conduction anesthesia in dental practice, has a pronounced local anesthetic effect. In tissues (in a slightly alkaline environment) it undergoes hydrolysis and releases a base that has lipophilic properties and easily penetrates the membrane into the nerve fiber.

Articaine interacts with receptors, blocks sodium channels in the nerve fiber membrane, thus providing a local anesthetic effect.

The effect of the drug begins quickly (the latent period is 1-3 minutes). Duration of action – 20 minutes. The rapid destruction of articaine to an inactive metabolite – articainic acid – is the reason for its very low toxicity, which allows repeated administration of the drug. In an acidic environment the effect is reduced.

Special instructions

Should not be administered intravenously!

Do not inject into the area of ​​inflammation.

To prevent infections (including hepatitis), it is necessary to ensure that new sterile syringes and needles are always used each time the solution is taken from the ampoule. Opened cartridges cannot be used again on other patients.

When removing premolars of the lower jaw in an uncomplicated stage, infiltration anesthesia gives the effect of conduction anesthesia. Infiltration mandibular anesthesia of the tongue and soft palate is ineffective – anesthesia with conduction anesthesia is required.

Patients require monitoring of the function of the cardiovascular system, respiratory system and central nervous system.

It is necessary to discontinue MAO inhibitors 10 days before the administration of a local anesthetic.

Impact on the ability to drive vehicles and engage in potentially hazardous activities

During the treatment period, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Use in childhood

The effectiveness and safety of the drug in children under 4 years of age have not been studied, so its use is contraindicated.

Active ingredient

Artikain

Composition

The solution for injection is transparent, colorless or with a yellowish tint.

1 ml articaine hydrochloride 40 mg

Excipients: sodium chloride – 2.1 mg, water up to 1 ml.

Contraindications

– hypersensitivity to articaine or other local anesthetic drugs of the amide group;

– megaloblastic B12-deficiency anemia;

– angle-closure glaucoma;

— diseases of the central nervous system;

— chronic hypoxia;

– bronchial asthma;

– paroxysmal tachycardia;

– atrial tachyarrhythmia;

– severe cardiac conduction disorders (for example, atrioventricular block II-III degree, severe bradycardia);

– acute heart failure;

– arterial hypotension;

– volumetric maxillofacial operations, as well as with intervention durations exceeding 20 minutes;

– children under 4 years of age (efficacy and safety have not been studied).

With caution

Women in labor with preeclampsia, bleeding in the last trimester of pregnancy.

Side Effects

The drug is usually well tolerated by patients, however, the following side effects may develop:

From the central and peripheral nervous system (dose-dependent): stupor, sometimes progressing to loss of consciousness, respiratory disorders, sometimes progressing to respiratory arrest, muscle tremors, muscle twitching, sometimes progressing to generalized convulsions.

Not dose-dependent – dizziness, paresthesia, hypoesthesia.

Sometimes, if the correct injection technique is not used when administering a local anesthetic in dental practice, nerve damage can occur, in particular in such cases, damage to the facial nerve can occur, which can lead to the development of facial paralysis.

On the part of the organ of vision: transient visual disturbances (blurred vision, blindness, double vision) that occur during or a short time after the injection of a local anesthetic.

From the cardiovascular system: decreased blood pressure, heart failure and shock.

From the digestive system: nausea, vomiting.

From the immune system: allergic reactions. At the injection site, they may manifest as swelling or inflammation of the mucous membrane. Manifestations not related to the injection site may include skin hyperemia, conjunctivitis, rhinitis and angioedema. Angioedema may manifest as swelling of the upper and/or lower lips, cheeks, swelling of the vocal cords with a feeling of a “lump in the throat” and difficulty swallowing, hives and difficulty breathing. Any of these manifestations can progress to anaphylactic shock.

Interaction

Local anesthetics enhance the effect of drugs that depress the central nervous system.

When used simultaneously:

– anticoagulants (ardeparin sodium, dalteparin sodium, danaparoid sodium, enoxaparin sodium, heparin, warfarin) increase the risk of hemorrhage and bleeding;

– monoamine oxidase inhibitors (MAO) (furazolidone, procarbazine, selegiline) increase the risk of arterial hypotension (MAO inhibitors must be discontinued 10 days before the administration of a local anesthetic);

– the effect of muscle relaxants is enhanced and prolonged;

– an additive effect develops with narcotic analgesics; respiratory depression increases;

– vasoconstrictors enhance and prolong the local anesthetic effect of articaine;

– cholinesterase inhibitors (antimyasthenic drugs, demecaria bromide, ecothiopathy chloride), cyclophosphamide, thiotepa reduce the metabolism of articaine.

Articaine exhibits antagonism with antimyasthenic drugs in its effect on skeletal muscles, especially when used in high doses, which requires additional adjustment in the treatment of myasthenia gravis.

When treating the injection site of a local anesthetic with disinfectant solutions containing heavy metals, the risk of developing a local reaction in the form of painful sensitivity and swelling increases.

The metabolite of procaine (para-aminobenzoic acid) is an antagonist of antimicrobial sulfonamide agents.

Overdose

Symptoms: dizziness, motor agitation or stupor during administration, loss of consciousness, decreased blood pressure, bradycardia.

Treatment: when the first signs of overdose appear, it is necessary to urgently stop the injection and place the patient in a horizontal position, ensure free passage of the airways, control the number of heartbeats and blood pressure. For dyspnea, apnea – oxygen, endotracheal intubation, artificial ventilation (central analeptics are contraindicated); for convulsions – slow intravenous short-acting barbiturates with simultaneous oxygen supply and hemodynamic control; in case of severe circulatory disorders and shock – intravenous infusion of electrolytes, glucocorticosteroids, plasma substitutes, albumin; in case of collapse and increasing bradycardia – epinephrine (adrenaline) 0.1 mg slowly intravenously, then intravenously by drip under the control of the number of heartbeats and blood pressure; for severe tachycardia and tachyarrhythmia – intravenous beta-blockers. Oxygen supply and control of blood circulation are necessary in all cases.

Manufacturer

Armavir biofactory FKP, Russia